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PRE EVENT INFORMATION
ASHBURTON WHEELS WEEK TT ONLINE ENTRY FORM
Sunday 5th May 2019 - Permit #18375
Hosted by Ashburton Motorcycle Club
Please refer
Supplementary Regulations
for full event information
Please submit a seperate entry for each competitor
Complete all compulsory fields and then click on 'Submit Entry' at bottom of page
CLASSES
Please select your class from the drop down list
Note: Classes will be finalised/confirmed from prepaid entries received by closing date;
Some classes may be combined or cancelled if sufficient entries haven't been received by this date.
*
Indicates required field
Class entered (select from drop down list)
*
.
Mini 4-6 years 50cc (little 50's -no SX's)
Mini 6-8 years 50cc MX (Big 50's)
Mini 7-11 years 65cc MX
Mini Trail 7-11 years (max 82cc 2 stroke or 149cc 4 stroke air cooled) *max 110cc for 7 year olds
Jnr 8-11yrs Pro 65cc (60-65cc 2 st) * mini or junior riders
Jnr 8-11yrs 85cc (60-85cc 2st +100-150cc 4st ) * Min 9yrs 150cc 4 st
Jnr 12-16yrs 85cc (60-85cc 2st +100-150cc 4st)
Jnr 12-16yrs 125cc (85-125cc 2 st)
Jnr 14-16 yrs 250cc (151-250-cc 4 st)
Ladies (15 yrs & over) per 16.13 age/bike capacity
MX1 (250cc & over 2 stroke & 4 stroke)
MX2 (upto 200cc 2 st & 250cc 4 st) * No 250cc 2 strokes
MX3 (any cc) 1st/2nd time riders, no double classing
Senior 2 Stroke (125cc & over 2 strokes only)
Vets 35-44 yrs (any cc)
Vets 45 yrs & over (any cc)
MX3 & Mini Licenced riders are not permitted to double class
COMPETITOR DETAILS
Race Number
*
Name
*
First
Last
Machine & Capacity
*
Email
*
Phone
*
Date of birth
DD
*
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31
MM
*
01
02
03
04
05
06
07
08
09
10
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12
YYYY
*
2015
2014
2013
2012
2011
2010
2009
2008
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2002
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1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
Age on race day
*
2nd Class Race Number
*
2nd Class (MX3 & Mini licenced riders no double classing)
*
.
Jnr 8-11yrs 85cc (60-85cc 2st +100-150cc 4st)
Jnr 12-16yrs 85cc (60-85cc 2st +100-150cc 4st)
Jnr 12-16yrs 125cc (90-125cc 2s)
Jnr 14-16 yrs 250cc (151-250cc 4 st)
Ladies (15 yrs & over) per 16.13 age/bike capacity
MX1 (250cc & over 2 stroke & 4 stroke)
MX2 (upto 200cc 2 st & 250cc 4 st) * No 250cc 2 strokes
MX3 (any cc) 1st/2nd time riders, no double classing
Senior 2 stroke (125cc & over 2 strokes only)
Vets 35-44 yrs (open cc)
Vets 45 yrs & over (any cc)
MX3 & Mini Licenced riders not permitted to double class
2nd Class Machine & Capacity
*
Address
*
Town/City
*
MNZ Licence # (or OE if require a One Event Licence)
*
Notes/Queries/Mylaps Transponder #
*
FEES
Choose Any
*
Senior classes - $70.00
Junior classes - $50.00
Mini classes - $40.00
2nd class entry - $30.00
One Event Licence Required - $30.00 (if you don't hold a MNZ licence)
Own Mylaps Transponder (provide pin number) Deduct $5
Late Entry - Compulsory from 6pm 3rd May
*
Late Entry Fee - $20.00
Intended Payment Method
*
Direct Credit
Cheque Being Sent
Total Payment $
*
Parent/Legal Guardian Name (to be present at event)
*
If rider is under 16 years of age on race day or under 18 years & requires a One Event Licence
DISCLAIMER OF LIABILITY: To Ashburton Motorcycle Club, and Motorcycling New Zealand Inc
.
I have read the Supplementary Regulations* for this Competition and agree to be bound by them and the Manual of Motorcycle Sport, the MNZ Constitution, and the MNZ Code of Conduct. * Supplementary Regulations also available at www.timingtech.co.nz
2. I am aware that the sport of Motorcycle Competition might a) cause me injury; serious or otherwise b) damage my property.
3. I wish to take part in the
Wheels Week TT
despite the above risks.
4. Neither I, or anyone associated or connected with me will make any claim against you or your officers, employees or agents in respect of: a) any injury suffered by me; or b) any damage to any of my property regardless of how the injury or damage occurs.
5. I will indemnify you against all claims, damages or losses (including costs) which you incur as the direct or indirect result of any injury to me or
damage to my property.
6. I am physically fit and there is no health or other reason why I should not participate in the sport of Motorcycle Competition.
7. I am aware that this disclaimer will not affect any legal obligations you have to me which you cannot contract out of under NZ Law.
8. I agree that in this disclaimer “my property” includes any property owned by me or in my possession or under my control.
9. I agree that this disclaimer will be binding on my family, my heirs, my legal assigns and my administrators and executors.
10. I accept that stripping and re-assembly for Technical Checks are at my cost.
11. I consent to the details contained in this form being held by the Ashburton
Motorcycle Club
for the purpose of the promotion and the benefit of
the race meeting concerned, and Motorcycling in general. I acknowledge my right to access and correction of this information. The consent is given in
accordance with the Privacy Act 1993.
12. MNZ supports the FIM/IOC Charter on drugs in Sport. MNZ uses the services of Drug Free Sport NZ & other agencies to professionally carry out the
testing. I acknowledge by signing this form I maybe subjected to a drug/alcohol test at any time. I agree to such testing. I further agree that my name
can be published by MNZ as having taken part in a drug/alcohol test together with the results of that testing.
13. I confirm that my machine complies with any technical rule(s) set out in the Manual of Motorcycle Sport and/or the Supplementary Regulations and
that, to the best of my knowledge and belief, it is in safe working order and fit for competition.
ONE EVENT LICENCE
– I do not have a MNZ Competition Licence therefore require a One Event Licence for this event:
In the absence of holding a MNZ Competition Licence, I acknowledge that I am able to compete by partaking on a One Event Licence. By reading and acknowledging this disclaimer, the Supplementary Regulations and the following rules I acknowledge that I adhere to all conditions to compete at this event using the One Event Licence.
The ability to compete whilst using a one event licence may be withdrawn at any time by Motorcycling New Zealand.
I acknowledge that I will wear an approve helmet, along with approved boots, gloves, and motocross clothing as per the MNZ Manual of Motorcycle Sport – see
www.mnz.co.nz
I acknowledge that no drugs or alcohol are permitted at this event, and I am not under the influence of either.
I acknowledge that I may be subject to random drug & alcohol testing as per the MNZ Manual of Motorcycle Sport.
I acknowledge that I have no medical condition that prevents me from safely participating in this event. I have not suffered concussion, or a head injury in the last three weeks.
My motorcycle is in a safe operating condition and type suited to the events that I am partaking in.
I acknowledge that attending riders briefing is compulsory
It is a condition of entry that all person having any connection with promotion, organisation, and conduct of the event including land owners, will be absolved from any liability out of any accident however caused and resulting in damage to property and or in respect of death or personal injury.
I fully indemnify Motorcycling New Zealand Inc., its agents representatives, employees, contractors, other competitors and promoters from and against any liability, whether or not due to any act or omission of these parties which arises from my participation in the event including by way of example any accident, damage or injury.
I agree that I have no medical condition that prevents me from safely participating in this event. I have not suffered concussion or had a head injury in the last three weeks. I acknowledge that should I suffer a head injury or concussion three weeks prior to this event that I will not partake due the MNZ stand down period.
Click Here for EVENT INFORMATION
and to see the terms and conditions for this event (Supplementary Regulations)
Any questions regarding this event, please refer to supplementary regs for
contact details of club officials.
I have read and accepted Terms and Conditions & Disclaimer above and I enter at my own risk
*
Yes
I confirm information I have supplied is correct
*
Yes
PAYMENT DETAILS
Cheques payable to – Ashburton Motorcycle Club, and post to
Wheels Week TT
C/- Adele May
Timing Tech
38 Davisons Road
2RD
TIMARU 7972
Direct Credit – Ashburton Motorcycle Club
06 - 0837 - 0022244 - 00
(Please include class & name & TT as ref)
Please make sure that you have filled out all * required fields.
Your entry has been sucessfully submitted if this page converts to one thanking you for your entry.
(Allow approx 20 seconds to submit)
If you have missed a field "Please correct the highlighted fields" will appear below Submit Entry and the applic field will be outlined in Red
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